Robinson D
N Engl J Med. 1977 Jul 28;297(4):188-93. doi: 10.1056/NEJM197707282970405.
Comparisons between the United Kingdom and the United States reveal definite differences in the style and content of primary medical practice. In the United States emphasis is on diagnosis. In the United Kingdom emphasis is on continuity and homebased care supported by a nationwide network of paramedical and social services. In both countries more is known about what discontents physicians than what satisfies patients. Medical practice and physician-patient relations are profoundly affected by external factors, including social attitudes, privileges, tradition, personal expectations and, above all, econimics. The American medical profession is the more exposed to external criticism, and future conflict and preoccupation with survival is largely an American phenomenon. Little is known in either cooutry about the long-term outcome of different forms of medical care. In Britain patients appear to value kindness above applied medical technology.
英国和美国的比较揭示了初级医疗实践在风格和内容上的明显差异。在美国,重点在于诊断。在英国,重点在于连续性以及由全国性辅助医疗和社会服务网络支持的居家护理。在这两个国家,人们对医生的不满了解得比对患者满意度的了解更多。医疗实践和医患关系受到外部因素的深刻影响,包括社会态度、特权、传统、个人期望,尤其是经济因素。美国医疗行业更容易受到外部批评,未来的冲突以及对生存的担忧在很大程度上是美国的现象。在这两个国家,对于不同形式医疗护理的长期结果了解甚少。在英国,患者似乎更看重友善而非应用的医疗技术。